Sexuality in perimenopausal and postmenopausal women

This article reviews psychosocial and biological aspects of the effects of menopause on sexuality. Sexuality is conceptualized as having multiple dimensions including desire, arousal, and orgasm. Population studies have revealed that postmenopausal status is associated with decline in these components of sexual functioning. While it is probable that psy-chological response to menopause affects sexual functioning, little re-search has addressed this issue. Considerable research has addressed the possible relationship between sexuality and menopausal hormone changes. Some research shows that low estrogen levels are associated with diminished sexual response and that estrogen replacement produces enhanced sexual response. Other studies, however, do not show this. Testosterone level is more clearly related to at least some measures of sexuality. Issues for future research are discussed. Sexuality is an important topic for postmenopausal women. This is espe-cially true now due to increased life expectancy of women. The average age of menopause (defined as the cessation of menses) has stayed relatively constant at 51.4 years (Jaszmann, 1973; McKinlay, Bifano, & McKinlay, 1985). Life expectancy, however, has increased dramatically over this cen-tury. In 1900, women’s life expectancy was 48.3 years (Department of Health, Education, and Welfare [DHEW], 1968); now a woman of 50 can expect to live an additional 30.9 years (Department of Health and Human Services [DHHS], 1988). Thus at the turn of the century a woman was likely to die before reaching menopause, whereas now at menopause she looks forward to a substantial portion of her life. The term menopause refers to cessation of menses. Because cycling be-comes irregular as menopause approaches and because amenorrhea due to other causes may precede menopause, researchers define natural meno